Wednesday, July 11, 2012

Massachusetts Ballot Question: An Act Relative to Death with Dignity [Summary]

State House


This proposed law would allow a physician licensed in
Massachusetts to prescribe medication, at a terminally ill
patient’s request, to end that patient’s life. To qualify, a
patient would have to be an adult resident who (1) is medically
determined to be mentally capable of making and communicating
health care decisions; (2) has been diagnosed by attending and
consulting physicians as having an incurable, irreversible
disease that will, within reasonable medical judgment, cause
death within six months; and (3) voluntarily expresses a wish to
die and has made an informed decision. The proposed law states
that the patient would ingest the medicine in order to cause
death in a humane and dignified manner.

The proposed law would require the patient, directly or
through a person familiar with the patient’s manner of
communicating, to orally communicate to a physician on two
occasions, 15 days apart, the patient’s request for the
medication. At the time of the second request, the physician
would have to offer the patient an opportunity to rescind the
request. The patient would also have to sign a standard form,
in the presence of two witnesses, one of whom is not a relative,
a beneficiary of the patient’s estate, or an owner, operator, or
employee of a health care facility where the patient receives
treatment or lives.

The proposed law would require the attending physician to:
(1) determine if the patient is qualified; (2) inform the
patient of his or her medical diagnosis and prognosis, the
potential risks and probable result of ingesting the medication,
and the feasible alternatives, including comfort care, hospice
care and pain control; (3) refer the patient to a consulting
physician for a diagnosis and prognosis regarding the patient’s
disease, and confirmation in writing that the patient is
capable, acting voluntarily, and making an informed decision;
(4) refer the patient for psychiatric or psychological
consultation if the physician believes the patient may have a
disorder causing impaired judgment; (5) recommend that the
patient notify next of kin of the patient’s intention; (6)
recommend that the patient have another person present when the
patient ingests the medicine and to not take it in a public
place; (7) inform the patient that he or she may rescind the
request at any time; (8) write the prescription when the
requirements of the law are met, including verifying that the
patient is making an informed decision; and (9) arrange for the
medicine to be dispensed directly to the patient, or the
patient’s agent, but not by mail or courier.

The proposed law would make it punishable by imprisonment
and/or fines, for anyone to (1) coerce a patient to request
medication, (2) forge a request, or (3) conceal a rescission of
a request. The proposed law would not authorize ending a
patient’s life by lethal injection, active euthanasia, or mercy
killing. The death certificate would list the underlying
terminal disease as the cause of death.

Participation under the proposed law would be voluntary.
An unwilling health care provider could prohibit or sanction
another health care provider for participating while on the
premises of, or while acting as an employee of or contractor
for, the unwilling provider.

The proposed law states that no person would be civilly or
criminally liable or subject to professional discipline for
actions that comply with the law, including actions taken in
good faith that substantially comply. It also states that it
should not be interpreted to lower the applicable standard of
care for any health care provider.

A person’s decision to make or rescind a request could not
be restricted by will or contract made on or after January 1,
2013, and could not be considered in issuing, or setting the
rates for, insurance policies or annuities. Also, the proposed
law would require the attending physician to report each case in
which life-ending medication is dispensed to the state
Department of Public Health. The Department would provide
public access to statistical data compiled from the reports.

The proposed law states that if any of its parts was held
invalid, the other parts would stay in effect.

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